Urological symptoms associated with non-prescribed ketamine use: A scoping review

Abstract

Background: Regular and repeated use of non‑prescribed ketamine is associated with urological symptoms (collectively referred to here as ketamine‑associated uropathy (KAU)). While severe cases requiring medical intervention are well‑documented, less is known about the broader range of symptoms experienced across diverse populations of people who use non‑prescribed ketamine, including those who do not seek clinical care. Existing evidence regarding how dose, route, frequency, and duration of ketamine use relate to the prevalence, type, and severity of urological symptoms remains fragmented and inconsistent. Objectives: This scoping review aims to map and synthesise the extent, nature, and characteristics of published research examining the relationship between patterns of non‑prescribed ketamine use (dose, frequency, duration, route of administration) and urological symptoms. Specifically, the review seeks to identify: (i) how different aspects of ketamine exposure relate to the prevalence, type, and severity of urological symptoms; (ii) which populations experience these symptoms; and (iii) how KAU symptoms and ketamine use are measured and reported in the existing literature. Methods: The review will follow Joanna Briggs Institute (JBI) guidance for scoping reviews and the PRISMA‑ScR reporting framework. PubMed, Web of Science, EMBASE, and Scopus will be searched using all potentially relevant primary studies published from 2000 onwards. Eligible studies will report measures of non‑prescribed ketamine use and any urological symptoms or clinical markers of KAU. Observational (including case studies/series) and experimental study designs will be included. Screening will be conducted in Covidence by two reviewers, with conflicts resolved by a third. Data will be extracted using an iteratively refined tool capturing ketamine exposure characteristics, urological outcomes, demographic data, and reporting methods. Findings will be presented descriptively and in tabular form. Expected Results: This review will map the range of reported urological outcomes associated with non‑prescribed ketamine use and describe how symptoms, exposures, and populations are characterised across the literature. It will also identify knowledge gaps, inconsistencies in exposure measurement, and areas requiring further clinical, epidemiological, or harm‑reduction research. Conclusions: By synthesising the existing evidence on ketamine exposure and urological outcomes, this review will support improved clinical recognition of early and sub‑clinical KAU, inform harm‑reduction knowledge, and guide future research priorities related to KAU.

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